20403 Biscayne BLVDPOLLO TROPICAL
20403 BISCAYNE BLVD
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660 -0008
n -nn r,ot Frond ms :rron •e Program Important: Read the instructions on pages 1 -9. Expiration Date: July 31, 2015
SECTION A— PROPERTY INFORMATION FORINSURANCECOMPANYUSE
Al. Building Owner's Name POLLO TROPICAL 'PoLCry Numbef. _
A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. "Compa 'NP[C Kumber " '
20403 BISCAYNE BLVD
City AVENTURA State FL ZIP Code 33180
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
A PORTION OF TRACTS A &B, " THE PROMENADE SHOPS ", PB. 133, PAGE 39 MIAMI -DADE COUNTY
A4, Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) NON - RESIDENTIAL
A5, Latitude /Longitude. Lat. 25.964897 Long. - 80.145989 Horizontal Datum: ❑ NAD 1927 E NAD 1983
AS Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7_ Building Diagram Number 1A
AS For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) NA sq ft a) Square footage of attached garage NA sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade NA within 1.0 foot above adjacent grade NA
c) Total net area of flood openings in A8.b NA sq in c) Total net area of flood openings in A9.b NA sq in
d) Engineered flood openings? ❑ Yes E No d) Engineered flood openings? ❑ Yes E No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name & Community Number B2. County Name B3. State
CITY OF AVENTURA 120676 MIAMI -DADE FL
B4. MaprPanel Number B5. Suffix B6. FIRM Index Date B7. FIRM Panel B8. Flood �AO, od Elevation(s) (Zone II.
1208600134 L 9 -11 -09 Effective /Revised Date Zones) base flood dept h)
9 -11 -09 AE 7.00
�310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile E FIRM ❑ Community Determined ❑ Other /Source:
B11. Indicate elevation datum used for BFE in Item B9: E NGVD 1929 ❑ NAVD 1988 ❑ Other /Source: _
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes E No
Designation Date: NA ❑ CBRS ❑ OPA
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
CT Building elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction` E Finished Construction
`A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations —Zones Al —A30, AE, AH, A (with BFE), VE, VI—V30, V (with BFE), AR, ARIA, AR/AE, AR/A1 —A30, AR/AH, AR/AO. Complete Items 1-2.a —h
below according to the building diagram specified in Item AT In Puerto Rico only, enter meters.
Benchmark Utilized COUNTY Vertical Datum: NGVD. 1929
Indicate elevation datum used for the elevations in items a) through h) below. ® NGVD 1929 ❑ NAVD 1988 ❑ Other /Source:
Datum used for building elevations must be the same as that used for the BFE.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
E Check here if comments are provided on back of form latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? E Yes ❑ No
Certifiers Name PEDRO LUIS MARTINEZ License Number LS5443
Title SURVEYOR AND MAPPER Company Name MARTINEZ AND MARTINEZ ENTERPRISE
Address 71
Signature
FEMA Form
(/111)
City HIALEAH
State FL ZIP Code 33014
irate 09 -05 -2014 Telephone 786 - 277 -4851
See reverse side for continuation.
Replaces all previous editions.
Check the measurement used
8.8
E feet
❑ meters
N.A
❑ feet
❑ meters
N.A
❑ feet
❑ meters
NA
❑ feet
❑ meters
9.3
E feet
❑ meters
8.1
E feet
❑ meters
8.4
E feet
❑ meters
NA
❑ feet
❑ meters
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
E Check here if comments are provided on back of form latitude and longitude in Section A provided by a
❑ Check here if attachments. licensed land surveyor? E Yes ❑ No
Certifiers Name PEDRO LUIS MARTINEZ License Number LS5443
Title SURVEYOR AND MAPPER Company Name MARTINEZ AND MARTINEZ ENTERPRISE
Address 71
Signature
FEMA Form
(/111)
City HIALEAH
State FL ZIP Code 33014
irate 09 -05 -2014 Telephone 786 - 277 -4851
See reverse side for continuation.
Replaces all previous editions.
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOB INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
20403 BISCAYNE BLVD
City AVENTURA State FL ZIP Code 33180 Company'NA4C: Number:
SECTION D- SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments HIGHEST CROWN OF ROAD ELEVATION =7.3'
USED GOOGLE EARTH TO OBTAIN LAT. AND LONG.
USED MIAMI -DADE COUNTY BENCHMARK E -190 ELEVATION= 7.42'.
WATER HEATER INSIDE BUILDING ON TOP OF CONCRETE. TOP OF CONCRETE ELEVATION = 9.30'.
Signature J Date 9 -05 -2014
SECTION - UILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones A d A (without BFE), complete Items E7-E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sections A. B,
and C. For Ite s E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the LAG.
F_2. For Building Diagrams 19 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is _ _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and /or equipment servicing the building is — _ ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community - issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
Check here if attachments.
SECTION G- COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items G8 -G10. In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO.
G3. ❑ The following information (Items G4 -G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued
i G8. Date Certificate Of Compliance/Occupancy Issued ll.
�
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement —
G8. Elevation of as -built lowest floor (including basement) of the building: _ _ ❑ feet ❑ meters Datum _
G9. BFE or (in Zone AO) depth of flooding at the building site: _ _ ❑ feet ❑ meters Datum _
G10 -. Community s design flood elevation: ❑ feet ❑ meters Datum
Local Officials Name Title
Community Name Telephone
Signature Date
Comments
❑ Check here if attachments
FEMA Form 066 -0-33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4
IMPORTANT: In these
Building Photographs
Continuation Page
�soonclina information from Section A.
P -itm ; 4
14 d 6s'z
FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number:
20403 BISCAYNE BLVD
City AVENTURA State FL ZIP Code 33180 1 Company NAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front VieW' and "Rear View; and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8.
NORTH SIDE
FEMA Form 086 -0 -33 (7/12) Replaces all previous editions.
ELEVATION CERTIFICATE, page 3 Building Photographs
See Instructions for Item A6.
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number:
20403 BISCAYNE BLVD
City AVENTURA
State FL ZIP Code 33180
NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
SOUTH SIDE
FEMA Form 086 -0 -33 (7/12) Replaces all previous editions.